How can schools and CAMHS work best together?

Transcription

1 How can schools and CAMHS work best together? Preliminary results from the national school survey Helen Sharpe & Miranda Wolpert In collaboration with Tamsin Ford, Chris Owen and Russell Viner 28 th July 2015

2 Schools and CAMHS: the challenge Rising need (Fink et al., 2015) Ongoing reduction in services (YoungMinds, 2014) Teachers most commonly contacted as point of advice for mental health issues (Ford et al., 2007) Long term challenges in relationship between schools and CAMHS (Fazel et al., 2014, Pettit, 2003) Increased diversity in educational sector

3 Schools and CAMHS: the opportunity Future in Mind (2015) stresses need for greater links between schools and CAMHS DfE funding projects to support this Recent survey of head teachers suggests mental health is a top priority for heads (The Key, 2015) Increasing range of initiatives to support mental health and wellbeing in schools, many being showcased today at this event.

4 We wanted to know: 1. What specialist support is available for young people with mental health difficulties in schools? 2. Who provides this specialist support? 3. Where do school staff refer/signpost young people with mental health difficulties for help? 4. What are the key barriers to schools accessing support for young people with mental health problems? 5. What are schools lived experiences of supporting the mental health of students and pupils?

5 The survey in action

6 With thanks to all those involved, including: Abbotskerswell Primary School Acland Burghley School Aldermoor Farm Primary School Ark Little Ridge Primary Academy Barmston Village Primary School Batchwood School Bethlem and Maudsley Hospital School Bridlewood Primary School Broadoak Primary School Bromet Primary School Bunwell Primary School Canons High School Central Bedfordshire UTC Cherry Willingham Community School Chesterton Community College Chilton County Primary School Church End Lower School Church of England Voluntary Controlled Upper School Condover CofE Primary School Cotwall End Primary School Countess Wear Community School Cuddington and Dinton CofE School Devon Hospitals' Short Stay School Dr Radcliffe's Church of England School Eardisley CofE Primary School Eastfield Primary School Emscote Infant School Exeter Mathematics School Farndon St Peter's CofE Primary School Field End Infant School Findern Primary School Five Acre Wood School Fountain Primary School Gnosall St Lawrence Coe Primary Academy Goodleigh Church of England Primary School Grafton Primary School Grampian Primary Academy Green Oaks Primary School Hamilton College Hampstead School Hawkswood Primary PRU Heathcoat Primary School Hellesdon High School Henry Cavendish Primary School Henry Tyndale School Highgate Wood Secondary School Hollingworth Primary School Holy Cross Church of England Primary School Holy Trinity CofE Primary School, NW3 Hull Trinity House Academy Ifield School Ilkley Grammar School Irthlingborough Infant School and Nursery Jack Hunt School Katherine Semar Junior School Keresforth Primary School Kingsweston School Larches House School Leatherhead Trinity School and Children's Centre Lexden Springs School Light Oaks Junior School Loddington CofE (VA) Primary School Manadon Vale Primary School Marshlands School Mayfield Primary School Meadow View Farm School Meadow View Primary School New End Primary School Newfield School Newton-le-Willows Primary School Oak Lodge School Oliver House School Our Lady and St John Catholic College Park View School Passmores Academy Pennington Infant School Pimlico Academy Priory Infant School Purley CofE Primary School Ralph Allen School Rotherham Aspire Samuel Rhodes MLD School Seal Primary Academy Skipton Girls' High School South Dartmoor Community College South Wilts Grammar School for Girls St Catherine's School St Cedd's Church of England Voluntary Aided Primary School, Bradwell St Crispin's Community Primary Infant School St David's Church of England Primary School St John's CofE (A) Primary School St Margaret's CofE Junior School St Neot Community Primary School St Nicholas CofE VA Primary School St Philip Howard Catholic School St Thomas' Catholic Primary School, Canterbury The Ashley School The Castle School The Holt School The John Henry Newman Catholic School The Primary School of St Mary and St Martin The Ridgeway School & Sixth Form College The Shrubberies School The St Christopher School The St Marylebone CofE School The Weston Road Academy The Willows CofE Primary School Thornhill Primary School Tormead School Trinity High School and Sixth Form Centre Warren Wood - A Specialist Academy West Hill School Westonbirt School Whitgreave Infant School Willesborough Junior School William Macgregor Primary School Windmill Primary School Wisbech St Mary CofE Aided Primary School Woodbridge Junior School Wootton Upper School AND MANY MORE!

7 Schools represented in the survey 587 school staff in England 60% school SLT / pastoral leads / inclusion managers 40% other school staff From 351 schools in 112 LAs Mean = 1.6 respondents per school (range 1 21) Mean = 5.1 respondents per LA (range 1 36)

8 Schools were primary & secondary, mostly mainstream, urban, non-fee paying, with a range of deprivation levels Other 11% Special 15% Rural 19% URBANICITY Secondary 41% PHASE Primary 48% PROVISION Mainstream 85% 41-50% FSM >50% FSM Urban 81% Fee paying 6% 31-40% FSM <10% FSM DEPRIVATION FUNDING Nonfee paying 94% 21-30% FSM 11-20% FSM

9 We under-represent primary, rural and feepaying schools, and over-represent special schools Other 11% Special 15% Rural 19% URBANICITY Secondary 41% PHASE Primary 48% Fee paying 6% PROVISION Mainstream 85% 31-40% FSM >50% FSM 41-50% FSM <10% FSM Urban 81% FUNDING Nonfee paying 94% 21-30% FSM DEPRIVATION 11-20% FSM

10 Number of students Categorising schools by their relative size 1600 Small Medium Large Primary Secondary All through / other Special

11 1. RESULTS AVAILABILITY OF SPECIALIST SUPPORT

12 Do you have specialist support for students with mental health problems within your school? No 28% Yes 72% 556 respondents

13 No differences in the reported level of specialist support between: Fee paying vs. non-fee paying schools Urban vs. rural schools Special vs. mainstream schools Schools with different levels of deprivation

14 Those in secondary schools report more specialist support than those in primary schools Primary Secondary No 18% No 43% Yes 57% Yes 82%

15 Those in relatively larger schools report more specialist support than those in relatively smaller schools Small Medium Large No 35% No 30% No 21% Yes 65% Yes 70% Yes 79%

16 % respondents % respondents How common are whole school approaches, curriculum time and staff training? 80% 80% 70% 70% 60% 60% 50% 50% 40% 40% 30% 30% 20% 20% 10% 10% 0% 'Whole school approaches' 0% Curriculum time Staff training 333 respondents

17 % Respondents What specific interventions are used in schools? 80% 70% 60% 50% 40% 30% 20% 10% 0% Therapy Nurture groups Family work Anger management Peer Support Mindfulness Themed support groups 333 respondents

18 % reporting using whole school approaches Whole school approaches are more common in schools with higher levels of deprivation 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% % FSM in school

19 Anger management Peer support Peer support and anger management are more common in secondary schools Primary Secondary No 85% Yes 15% No 63% Yes 37% No 67% Yes 33% No 46% Yes 54%

20 Family work is more common in urban schools Urban Rural No 43% Yes 32% Yes 57% No 68%

21 Mindfulness is more common in special schools Mainstream Special Yes 22% Yes 42% No 58% No 78%

22 2: RESULTS WHO PROVIDES THIS MENTAL HEALTH SUPPORT?

23 % reporting each specialist Specialists providing support in school 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Counsellor Clinical psychologist Educational psychologist External agency (e.g. drugs) 333 respondents

24 Counsellors are more common in secondary schools Primary Secondary No 19% No 51% Yes 49% Yes 81%

25 Clinical psychologists are more common in special schools and in larger schools Mainstream Special Yes 17% Yes 36% No 83% No 64% Small Yes 6% Medium Yes 28% Large Yes 21% No 94% No 72% No 79%

26 % Schools Use of external agencies is more common in secondary schools and in schools with higher levels of deprivation No 74% Primary Yes 26% Secondary No 26% Yes 74% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% % FSM in school

27 % respondents Who provides this support in schools? 70% 60% 50% 40% 30% 20% 10% 0% NHS Voluntary sector Private services LA Don t know 316 respondents

28 % respondents Secondary schools report more support provided by NHS CAMHS and voluntary sector than primary schools 90% 80% Primary Secondary 70% 60% 50% 40% 30% 20% 10% 0% NHS CAMHS Voluntary sector

29 3. RESULTS REFERRING STUDENTS FOR SUPPORT

30 % very likely to refer/signpost School staff are most likely to direct students with mental health problems to NHS CAMHS 80% 70% 60% 50% 40% 30% 20% 10% 0% Help themselves Specialist help in school NHS CAMHS Vol/Ind CAMHS respondents

31 % very likely to refer/signpost Compared with other difficulties, self harm is more likely to be referred to specialist help within school 80% Specialist support within school 70% 60% 50% 40% 30% 20% 10% 0% Depression Anxiety Self harm Behavioural problems respondents

32 % reporting 'very likely to refer/signpost within school Those in schools with greater levels of deprivation are more likely to refer students to services within school 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% % FSM in school

33 % reporting 'very likely to refer/signpost within school Special schools are more likely to refer students to services within school 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Mainstream Special

34 % respondents Specialist services in school are viewed as being particularly helpful 100% 90% 80% 70% 60% 50% 40% Helped Neutral Made worse 30% 20% 10% 0% Specialist help in school NHS CAMHS Vol/Ind CAMHS respondents

35 % respondents Specialist services in schools are viewed as providing particularly good feedback 100% 90% 80% 70% 60% Good 50% 40% 30% Poor Not aware of any feedback 20% 10% 0% Specialist help in school NHS CAMHS Vol/Ind CAMHS respondents

36 4. RESULTS BARRIERS TO SUPPORT

37 % rating as 'very much' a barrier Capacity of provision is viewed as the greatest barrier to supporting mental health in students 70% 60% 50% 40% 30% 20% 10% 0% Capacity of NHS CAMHS Capacity of vol/ind CAMHS Funding Availability of specialists National policy School staff capacity Knowing what support is available Attitudes towards mental health Links with agencies respondents

38 5. RESULTS SCHOOLS LIVED EXPERIENCES

39 1. Recognition of the difficulties all services are facing due to funding shortages Anyone at CAMHS who is working under the conditions they are working under and dealing with their impossible tasks on a day to day basis deserves our complete admiration and respect. CAMHS is doing the best that they can with the very limited resources that they have - we now don't even bother referring to CAMHS unless we can justifiably say there is clear and present risk of significant harm to either themselves or others around them. The chronic funding shortage is just storing up problems for the future. It is the untold scandal in education of our generation.

40 2. Perceived increasing reliance on schools due to funding shortages Over the years the burden on schools to deal with mental health issues has increased dramatically but there has been very little investment in this year. Schools are having to 'pick up the pieces' that social services, the NHS and other organisations should be dealing with and schools lack the time, money and training to deal with the wide range of issues.

41 3. Wish for increased skills and knowledge in schools Experiencing the frustration of trying to help and support students and their families during school time but having only limited knowledge about what resources are available, waiting lists etc. and who best to signpost them to for more help. Feel completely overwhelmed. I feel I have no specialist skills in the area and am struggling to support the number of students that present. Also lack of time means I feel we are not picking up the students early so that issues do not escalate.

42 4. Wish for emotional support for school staff It is often very distressing to see a student in that state and we as teachers hold onto that load for many of our students. There should be counselling available for teachers (or publicity about it)

43 5. Concern about academic pressures as key risk factor Schools need to rethink the pressure of academic achievement and constant targets and equally value each child's happiness and well being. So many students crack under the pressure and are not totally supported when they do. The pressure from the government is really felt by teachers and this filters down to the students. Change needs to come from the top! I think the pressure that the current education puts on young people to enormous and can trigger or exacerbate mental health difficulties for students.

44 6. Concern about lack of application of evidence based practice Many mental health issues are well understood in terms of cause and treatment. However, as a society we are not applying this knowledge when young people display clear symptoms nor, indeed preventatively with regard to parenting. This is analogous to living in a feudal agricultural society whilst having our current advanced scientific and technological expertise.

45 SUMMING UP

46 In summary Schools are expressing the burden of trying to support young people in distress. Schools recognise the challenges both they and CAMHS face, and often feel frustrated by this. Attitudes/stigma around mental health are not perceived to be the main barrier, but rather lack of capacity for provision of specialist help On the whole there were few differences between schools, but relatively larger schools and secondary schools tended to report greater provision.

47 The problem does not appear to be attitudes or stigma. The problem appears to be capacity. How do we jointly address this?